MEDICARE: MR. GRADY W STONE JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	138616	AL

General Provider Information

NPI Number	:	1164934360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GRADY W STONE JR.

Provider Business Mailing Address
First Line	:	2011 HIGHWAY 280 BYP
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3624
Country	:	US
Telephone Number	:	334-480-4015
Fax Number	:	334-448-9918

Provider Business Practice Location Address
First Line	:	2011 HIGHWAY 280 BYP
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3624
Country	:	US
Telephone Number	:	334-480-4015
Fax Number	:	334-448-9918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2017
Last Update Date	:	02/17/2026

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Directions to “ MR. GRADY W STONE JR. ” Practice Location

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